Healthcare Provider Details

I. General information

NPI: 1780177733
Provider Name (Legal Business Name): BEATRIZ GUERRA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 BARSTOW AVE
CLOVIS CA
93612-2230
US

IV. Provider business mailing address

750 E ALMOND AVE
MADERA CA
93637-5617
US

V. Phone/Fax

Practice location:
  • Phone: 559-314-2408
  • Fax:
Mailing address:
  • Phone: 559-664-4000
  • Fax: 559-675-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025531
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: